A clinician''s perspective: Comments on identification of stuttering, prevention, and early intervention

I am responding to the Hamre article on the identification and prevention o stuttering and to what was said by those who commented in the recent Special Forum Issue. My discussion will be in terms of my understanding and one of my major career objectives, that of translating reported research and clinical experience in a meaningful and useful way for students and professional clinicians.     

Procedural fairness and self-esteem

We argue that people's self-esteem is affected by the fairness of procedures to which they are subjected; unfair treatment will lower self-esteem. Moreover, since this influence on self-esteem is presumably due to the implicit evaluation expressed by the choice of procedure and hence by the evaluation expressed by the person implementing the procedure, people's concern with the fairness of treatment will be focused on the interactional aspects of the procedure. In two experiments designed to test these hypotheses subjects received either a high or a low grade on an ability test on the basis of either fair or unfair grading procedures. The results of Experiment 1 indicated that subjects' self-esteem was lower after unfair treatment, and this influence was only apparent when subjects received high test feedback. Additionally, ratings of the fairness of the interaction were lower following unfair grading procedures. Experiment 2 also manipulated level of involvement with the test. Self-esteem was affected by procedural fairness and procedural fairness influenced perceived fairness of the interaction only in the high involvement condition.     

Racial bias and the MCMI

We studied the scores obtained on the Millon Clinical Multiaxial Inventory (MCMI) by Black and White male psychiatric inpatients to determine the presence or absence of racial bias. In predicting psychopathology for the two races, comparisons of MCMI performance indicated significant differences for all diagnoses except the personality disorders. The subjects were then matched into two groups of 209 patients each, according to DSM-III psychiatric diagnoses. The data were analyzed at the item, scale, and structural levels. At the item level, application of the Mantel-Haenszel Procedure revealed that 45 of the 175 items of the inventory were answered significantly different by the two racial groups. Because this number was higher than what could be expected by chance, the finding suggested possible deficiencies in terms of the culture-fairness of the items used in the test. At the scale level, an analysis of variance (ANOVA) demonstrated that the scores obtained by the Black and White groups were significantly different in 9 of the 20 scales (Histrionic, Narcissistic, Antisocial, Paraphrenia, Hypomania, Dysthymia, Alcohol Abuse, Drug Abuse, and Psychotic Delusion). With the exception of the Dysthymic scale, all of the differences were in the direction of the Blacks obtaining a higher score than the Whites. At the structural level, however, a principal components factor analysis performed on each group resulted in factor structures that looked identical.     

Converging operations on a basic level in event taxonomies

Research on object concepts has identified one level of abstraction as "basic" in cognition and communication. We investigated whether concepts for routine social events have a basic level by replicating the converging operations used to investigate object concepts. In Experiment 1, subjects were presented with event names from a taxonomy and were asked to list the actions comprising the event. Many more actions were listed at the middle than at the highest taxonomic level, without a further increase at the most specific level, paralleling the pattern of superordinate-, basic-, and subordinate-level object concepts. From these action lists, brief stories were composed for each event. In Experiment 2, subjects made pairwise similarity judgments on the stories. The mean similarity of events increased with specificity, as expected. But differentiation of categories (within-category similarity compared to between-category similarity) was highest for super-ordinates, contrary to results with object categories. In Experiment 3, subjects were fastest in recognizing actions as belonging to events named at the basic level. In Experiment 4, subjects predominantly chose basic-level terms to name stories. We conclude that event taxonomies do show basic-level structure, albeit a less sharply defined and less stable structure than in object taxonomies. The benefits and hazards of extending models of object concepts to other entities, such as social events, are discussed.     

An on-line assessment of causal reasoning during comprehension

Fletcher and Bloom (1988) have argued that as readers read narratives, clause by clause, they repeatedly focus their attention on the last preceding clause that contains antecedents but no consequences in the text. This strategy allows them to discover a causal path linking the text's opening to its final outcome while minimizing the number of times long-term memory must be searched for missing antecedents or consequences. In order to test this hypothesis, we examined the reading times of 25 subjects for each clause of eight simple narrative texts. The results show that: (1) causal links between clauses that co-occur in short-term memory (as predicted by the strategy) increase the time required to read the second clause; (2) potential causal links between clauses that never co-occur in short-term memory (again as predicted by the strategy) have no effect on reading time; and (3) reinstatement searches are initiated at the end of sentences that are causally unrelated to the contents of short-term memory or that contain clauses that satisfy goals no longer in short-term memory. These results support the claim that subjects engage in a form of causal reasoning when they read simple narrative texts.     

Maladjustment in statistical minorities within ethnically unbalanced classrooms

Ascertained if being a member of a statistical minority influences children's adjustment in school, as measured by the AML, a teacher-administered adjustment rating scale. Teachers from a southwest school district evaluated elementary students on aggressive, acting-out behaviors, moody-internalized behaviors, and learning difficulties. Analyses conducted on 376 students revealed significant effects of statistical minority status on certain dimensions of adjustment ratings for both Hispanic and Anglo students. Hispanic students in the statistical minority received poorer ratings on the moodiness dimension of the AML than nonminority Hispanic students. Anglo students in the statistical minority received poorer ratings on the aggression dimension of the AML than nonminority Anglo students. These results were interpreted in terms of cultural differences in coping with statistical minority status. Traits commonly exhibited within a culture may intensify and be perceived as maladaptive when stress resulting from being a minority occurs. Implications of the finding that statistical minority status within the school environment influences adjustment are discussed.     

Testosterone and personality among college students and military veterans

Relationships of serum and saliva to personality were examined among 401 college students in four laboratory studies and 5,236 military veterans in one archival study. Among the students, there were few relationships between testosterone and traditional personality measures. Among the veterans, MMPI scores and DSM-III diagnoses showed testosterone related to drug and alcohol abuse, antisocial and generally intemperate behavior, and effective disorders. Consistent with social control theory, correlations were higher among veterans who were lower in socioeconomic status. It appears likely that testosterone has innate effects that are socially undesirable but can be attenuated by bonds between the individual and society. Effect sizes were small, suggesting that testosterone will have noticeable effects only in large populations or individuals who differ markedly from the population mean. Further research should focus upon antisocial correlates of testosterone and conditions that produce marked changes in testosterone levels.